Effects of Point-of-Care Ultrasound in Multidisciplinary Medical Wards

Point-of-care ultrasound (POCUS) is a bedside portable ultrasound technique utilized by healthcare providers to offer rapid and non-invasive diagnostic imaging. POCUS has proven particularly effective in critical care and emergency settings. However, its application in general medical wards, where patients often present with multiple comorbidities, remains under-researched. Additionally, the feasibility of nurse practitioners (NPs) performing POCUS is promising. Despite limited research on POCUS by less experienced operators, NP-conducted POCUS could provide timely, high-quality care, especially in situations with limited physician availability. The routine use of POCUS in patient admissions to medical wards may improve diagnostic accuracy, reduce diagnostic resource utilization, and shorten hospital stays.

Study Overview

• Status: Completed
• Conditions: Point-of-care Ultrasound
• Intervention / Treatment: Other: Point-of-Care Ultrasound

Detailed Description

Point-of-care ultrasound (POCUS) is a bedside portable ultrasound technique utilized by healthcare providers to offer rapid and non-invasive diagnostic imaging. This method significantly aids in diagnosis and treatment by enhancing accuracy, guiding treatment adjustments, aiding procedural interventions, and reducing the time to appropriate treatment, ultimately leading to better patient outcomes. POCUS also decreases the reliance on other imaging modalities, providing real-time information and minimizing additional imaging needs.

POCUS has proven particularly effective in critical care and emergency settings. However, its application in general medical wards, where patients often present with multiple comorbidities, remains under-researched. The potential value of POCUS in these wards is notable, as it can facilitate early complication detection and timely treatment adjustments, reducing complication incidences.

Additionally, the feasibility of nurse practitioners (NPs) performing POCUS is promising. NPs, as frontline healthcare professionals, can use POCUS to enhance diagnostic and therapeutic capabilities. Despite limited research on POCUS by less experienced operators, NP-conducted POCUS could provide timely, high-quality care, especially in situations with limited physician availability. The routine use of POCUS in patient admissions to medical wards may improve diagnostic accuracy, reduce diagnostic resource utilization, and shorten hospital stays.

• Study Type: Interventional
• Enrollment (Actual): 144
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Taiwan
  • Taipei, Taiwan, 100
    • National Taiwan University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion criteria:

1. Age 18 years or older
2. Admitted directly from emergency department

Exclusion criteria:

1. End-of-life care
2. Immediate need for life-support therapy or ICU transfer
3. Airborne isolation

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Diagnostic
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Group PoCUS; Participants assigned to Group PoCUS will undergo point-of-care ultrasound evaluations by nurse practitioners/physicians within their first 24 hours of admission to the general ward.	Other: Point-of-Care Ultrasound; The investigators will use point-of-care ultrasound to exam participants including lungs, heart, liver, spleen, kidney and bladder, etc.
No Intervention: Group Usual Care; Participants assigned to Group Usual Care will receive usual standard care.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Proportion of accurate diagnosis	The proportion of accurate physician diagnosis achieved at 48 hours after admission to medical wards	At 48 hours after admission to medical wards

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hospital mortality	Rate of hospital mortality of the participants	Until death, hospital discharge or up to 28 days
Rate of ICU transfer	Rate of participants requiring ICU care	Within 7 days after admission to medical wards
Length of hospital stay	The length of hospital stay of the participants	Until death, hospital discharge or up to 28 days
Categories and numbers of invasive procedures	Categories and numbers of invasive procedures required by the participants	Within 7 days after admission to medical wards
Categories and numbers of imaging studies	The requests for additional categories and numbers of imaging studies for the participants	Within 7 days after admission to medical wards

Collaborators and Investigators

• Sponsor: National Taiwan University Hospital
• Investigators: Principal Investigator: Chun-Ta Huang, MD, National Taiwan University Hospital

Publications and helpful links

General Publications

• Teare MD, Dimairo M, Shephard N, Hayman A, Whitehead A, Walters SJ. Sample size requirements to estimate key design parameters from external pilot randomised controlled trials: a simulation study. Trials. 2014 Jul 3;15:264. doi: 10.1186/1745-6215-15-264.
• Manno E, Navarra M, Faccio L, Motevallian M, Bertolaccini L, Mfochive A, Pesce M, Evangelista A. Deep impact of ultrasound in the intensive care unit: the "ICU-sound" protocol. Anesthesiology. 2012 Oct;117(4):801-9. doi: 10.1097/ALN.0b013e318264c621.
• Bernier-Jean A, Albert M, Shiloh AL, Eisen LA, Williamson D, Beaulieu Y. The Diagnostic and Therapeutic Impact of Point-of-Care Ultrasonography in the Intensive Care Unit. J Intensive Care Med. 2017 Mar;32(3):197-203. doi: 10.1177/0885066615606682. Epub 2016 Jul 9.
• Zieleskiewicz L, Muller L, Lakhal K, Meresse Z, Arbelot C, Bertrand PM, Bouhemad B, Cholley B, Demory D, Duperret S, Duranteau J, Guervilly C, Hammad E, Ichai C, Jaber S, Langeron O, Lefrant JY, Mahjoub Y, Maury E, Meaudre E, Michel F, Muller M, Nafati C, Perbet S, Quintard H, Riu B, Vigne C, Chaumoitre K, Antonini F, Allaouchiche B, Martin C, Constantin JM, De Backer D, Leone M; CAR'Echo and AzuRea Collaborative Networks. Point-of-care ultrasound in intensive care units: assessment of 1073 procedures in a multicentric, prospective, observational study. Intensive Care Med. 2015 Sep;41(9):1638-47. doi: 10.1007/s00134-015-3952-5. Epub 2015 Jul 10.
• Zieleskiewicz L, Lopez A, Hraiech S, Baumstarck K, Pastene B, Di Bisceglie M, Coiffard B, Duclos G, Boussuges A, Bobbia X, Einav S, Papazian L, Leone M. Bedside POCUS during ward emergencies is associated with improved diagnosis and outcome: an observational, prospective, controlled study. Crit Care. 2021 Jan 22;25(1):34. doi: 10.1186/s13054-021-03466-z.
• Ben-Baruch Golan Y, Sadeh R, Mizrakli Y, Shafat T, Sagy I, Slutsky T, Kobal SL, Novack V, Fuchs L. Early Point-of-Care Ultrasound Assessment for Medical Patients Reduces Time to Appropriate Treatment: A Pilot Randomized Controlled Trial. Ultrasound Med Biol. 2020 Aug;46(8):1908-1915. doi: 10.1016/j.ultrasmedbio.2020.03.023. Epub 2020 May 16.
• Arvig MD, Lassen AT, Gaede PH, Gartner SW, Falster C, Skov IR, Petersen HO, Posth S, Laursen CB. Impact of serial cardiopulmonary point-of-care ultrasound exams in patients with acute dyspnoea: a randomised, controlled trial. Emerg Med J. 2023 Oct;40(10):700-707. doi: 10.1136/emermed-2022-212694. Epub 2023 Aug 18.
• Patel S, Green A, Ashokumar S, Hoke A, Rachoin JS. Objective Methods of Assessing Fluid Status to Optimize Volume Management in Kidney Disease and Hypertension: The Importance of Ultrasound. J Clin Med. 2023 Oct 5;12(19):6368. doi: 10.3390/jcm12196368.
• Pontet J, Yic C, Diaz-Gomez JL, Rodriguez P, Sviridenko I, Mendez D, Noveri S, Soca A, Cancela M. Impact of an ultrasound-driven diagnostic protocol at early intensive-care stay: a randomized-controlled trial. Ultrasound J. 2019 Sep 30;11(1):24. doi: 10.1186/s13089-019-0139-2.
• Wang PH, Chen JY, Ling DA, Lee AF, Ko YC, Lien WC, Huang CH. Earlier point-of-care ultrasound, shorter length of stay in patients with acute flank pain. Scand J Trauma Resusc Emerg Med. 2022 Apr 21;30(1):29. doi: 10.1186/s13049-022-01017-1.
• Riishede M, Lassen AT, Baatrup G, Pietersen PI, Jacobsen N, Jeschke KN, Laursen CB. Point-of-care ultrasound of the heart and lungs in patients with respiratory failure: a pragmatic randomized controlled multicenter trial. Scand J Trauma Resusc Emerg Med. 2021 Apr 26;29(1):60. doi: 10.1186/s13049-021-00872-8.
• Mozzini C, Di Dio Perna M, Pesce G, Garbin U, Fratta Pasini AM, Ticinesi A, Nouvenne A, Meschi T, Casadei A, Soresi M, Cominacini L. Lung ultrasound in internal medicine efficiently drives the management of patients with heart failure and speeds up the discharge time. Intern Emerg Med. 2018 Jan;13(1):27-33. doi: 10.1007/s11739-017-1738-1. Epub 2017 Aug 12.
• Fraleigh CDM, Duff E. Point-of-care ultrasound: An emerging clinical tool to enhance physical assessment. Nurse Pract. 2022 Aug 1;47(8):14-20. doi: 10.1097/01.NPR.0000841944.00536.b2.
• Atkinson PR, Milne J, Diegelmann L, Lamprecht H, Stander M, Lussier D, Pham C, Henneberry R, Fraser JM, Howlett MK, Mekwan J, Ramrattan B, Middleton J, van Hoving DJ, Peach M, Taylor L, Dahn T, Hurley S, MacSween K, Richardson LR, Stoica G, Hunter S, Olszynski PA, Lewis DA. Does Point-of-Care Ultrasonography Improve Clinical Outcomes in Emergency Department Patients With Undifferentiated Hypotension? An International Randomized Controlled Trial From the SHoC-ED Investigators. Ann Emerg Med. 2018 Oct;72(4):478-489. doi: 10.1016/j.annemergmed.2018.04.002. Epub 2018 Jun 2.
• Yamada T, Ehara J, Funakoshi H, Endo K, Kitano Y. Effectiveness of point of care ultrasound (POCUS) simulation course and skills retention for Japanese nurse practitioners. BMC Nurs. 2023 Jan 23;22(1):21. doi: 10.1186/s12912-023-01183-2.
• Huang C, Morone C, Parente J, Taylor S, Springer C, Doyle P, Temin E, Shokoohi H, Liteplo A. Advanced practice providers proficiency-based model of ultrasound training and practice in the ED. J Am Coll Emerg Physicians Open. 2022 Jan 11;3(1):e12645. doi: 10.1002/emp2.12645. eCollection 2022 Feb.
• Lee SH, Yun SJ. Diagnostic performance of emergency physician-performed point-of-care ultrasonography for acute appendicitis: A meta-analysis. Am J Emerg Med. 2019 Apr;37(4):696-705. doi: 10.1016/j.ajem.2018.07.025. Epub 2018 Jul 14.

Study record dates

Study Major Dates

• Study Start (Actual): August 1, 2024
• Primary Completion (Actual): October 25, 2024
• Study Completion (Actual): December 17, 2024

Study Registration Dates

• First Submitted: July 8, 2024
• First Submitted That Met QC Criteria: July 28, 2024
• First Posted (Actual): July 31, 2024

Study Record Updates

• Last Update Posted (Actual): November 19, 2025
• Last Update Submitted That Met QC Criteria: November 16, 2025
• Last Verified: October 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: 202405109RINA

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No